Disrupted day–night pattern of cardiovascular death in obstructive sleep apnea

Martins, Emerson Ferreira; Martinez, Dênis; Silva, Fernando A. Boeira Sabino da; Sezerá, Lauren; Camargo, Rodrigo; Fiori, Cíntia Zappe; Fuchs, Flávio Danni; Moraes, Roque

doi:10.1016/j.sleep.2017.06.027

Cited by 16 publications

(6 citation statements)

References 30 publications

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“…Conversely, the literature on ventricular arrhythmias is relatively scarce and heterogeneous, as pointed out by a recent review [43]. Incidence of sudden cardiac death is increased at night in OSA according to some reports [44] while other studies found a uniform distribution over 24 hours [45]. Studies in patients with implantable cardioverter-defibrillator devices (ICD) have reported a high frequency of nocturnal discharge in OSA compared to non-OSA patients [46] or patients with chronic heart failure and central apneas [47, 48].…”

Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

Bonsignore

Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

178

116

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Obstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and cancer. Better phenotypic characterization of OSA patients, including comorbidities, will help to provide better individualized care. The unsatisfactory adherence to CPAP in patients without daytime sleepiness should prompt clinicians to examine the overall risk profile of each patient in order to identify subjects at high risk for worse prognosis and provide the optimal treatment not only for OSA, but also for comorbidities.

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Section: Common Comorbidities In Osa Patientsmentioning

confidence: 99%

Obstructive sleep apnea and comorbidities: a dangerous liaison

Bonsignore

Baiamonte

Mazzuca

et al. 2019

Multidiscip Respir Med

178

116

View full text Add to dashboard Cite

show abstract

“… 97 According to a recent larger investigation, sudden cardiac deaths were evenly distributed in the 24 hours in OSA patients, whereas non-OSA subjects died preferentially in the morning. 98 Two studies pointed out that in OSA patients, the onset of acute coronary syndrome was more frequent in the nocturnal hours, differently from subjects without OSA. 99 , 100 In addition, a few studies showed that wakeup strokes were strongly associated with OSA.…”

Section: Bp Variability In Osamentioning

confidence: 99%

Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

Marrone

Bonsignore

2018

NSS

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Obstructive sleep apnea (OSA) is often associated with hypertension and other cardiovascular diseases. Blood pressure (BP) variability is part of the assessment of cardiovascular risk. In OSA, BP variability has been studied mainly as very short-term (beat-by-beat) and short-term (24-hour BP profile) variability. BP measured on consecutive heartbeats has been demonstrated to be highly variable, due to repeated peaks during sleep, so that an accurate assessment of nocturnal BP levels in OSA may require peculiar methodologies. In 24-hour recordings, BP frequently features a “nondipping” profile, ie, <10% fall from day to night, which may increase cardiovascular risk and occurrence of major cardiovascular events in the nocturnal hours. Also, BP tends to show a large “morning BP surge”, a still controversial negative prognostic sign. Increased very short-term BP variability, high morning BP, and nondipping BP profile appear related to the severity of OSA. Treatment of OSA slightly reduces mean 24-hour BP levels and nocturnal beat-by-beat BP variability by abolishing nocturnal BP peaks. In some patients OSA treatment turns a nondipping into a dipping BP profile. Treatment of arterial hypertension in OSA usually requires both antihypertensive pharmacological therapy and treatment of apnea. Addressing BP variability could help improve the management of OSA and reduce cardiovascular risk. Possibly, drug administration at an appropriate time would ensure a dipping-BP profile.

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“…In recent years, the prevalence of OSA has shown an increasing trend. OSA patients who experience hypoxia during sleep and are not treated for a long time may experience a variety of serious cardiovascular and cerebrovascular diseases, and even sudden death at night [3,4]. A recent study by Franklin et al [5] showed that OSA was present in 22% of male patients and 17% of female patients; women with OSA were more likely to develop hypertension, obesity, and other cardiovascular and cerebrovascular diseases that are age-related; and women with OSA may have clinical manifestations that differ from those of men, making the diagnosis more difficult.…”

Section: Introductionmentioning

confidence: 99%

Alcohol as an independent risk factor for obstructive sleep apnea

et al. 2021

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Background To determine if alcohol consumption is a risk factor for obstructive sleep apnea (OSA) and nocturnal oxygen desaturation. Methods This case–control study evaluated patients with confirmed OSA and a control group using polysomnography (PSG). Two doctors who have worked in this field for more than 5 years provided a blinded interpretation of the patients’ monitoring results. Logistic regression models were used to identify the odds ratio (OR) for alcohol consumption on OSA. Results A total of 793 patients were enrolled in this study. Compared with those who did not consume alcohol, those consuming alcohol had a higher risk of OSA (OR 2.03, 95% CI 1.30–3.17) after adjustment. Regarding the risk of OSA after adjusting for former drinkers and current ones, the ORs were 1.96 (95% CI 1.19–3.22) and 2.22 (95% CI 1.06–4.63), respectively. And the P for trend = 0.002. The β of former drinkers and the current ones were 3.448 and 4.560 after adjustment; P for trend was 0.006. The relationship may have gender difference, and alcohol consumption was associated with AHI in female significantly (β = 10.190 and 15.395 for former and current drinkers, respectively, in females after adjustment, P for trend = 0.002). Conclusions In this study, we found that alcohol consumption was an independent risk factor of OSA and OSA with hypoxia, and alcohol consumption was related to AHI significantly after adjustment, especially in female. In order to reduce the risk and severity of OSA, it is suggested that people should avoid drinking, and drinkers should abstain from drinking.

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Disrupted day–night pattern of cardiovascular death in obstructive sleep apnea

Cited by 16 publications

References 30 publications

Obstructive sleep apnea and comorbidities: a dangerous liaison

Obstructive sleep apnea and comorbidities: a dangerous liaison

Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

Alcohol as an independent risk factor for obstructive sleep apnea

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